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1.
Trends Hear ; 24: 2331216520945826, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32895034

RESUMO

It is well known that hearing loss compromises auditory scene analysis abilities, as is usually manifested in difficulties of understanding speech in noise. Remarkably little is known about auditory scene analysis of hearing-impaired (HI) listeners when it comes to musical sounds. Specifically, it is unclear to which extent HI listeners are able to hear out a melody or an instrument from a musical mixture. Here, we tested a group of younger normal-hearing (yNH) and older HI (oHI) listeners with moderate hearing loss in their ability to match short melodies and instruments presented as part of mixtures. Four-tone sequences were used in conjunction with a simple musical accompaniment that acted as a masker (cello/piano dyads or spectrally matched noise). In each trial, a signal-masker mixture was presented, followed by two different versions of the signal alone. Listeners indicated which signal version was part of the mixture. Signal versions differed either in terms of the sequential order of the pitch sequence or in terms of timbre (flute vs. trumpet). Signal-to-masker thresholds were measured by varying the signal presentation level in an adaptive two-down/one-up procedure. We observed that thresholds of oHI listeners were elevated by on average 10 dB compared with that of yNH listeners. In contrast to yNH listeners, oHI listeners did not show evidence of listening in dips of the masker. Musical training of participants was associated with a lowering of thresholds. These results may indicate detrimental effects of hearing loss on central aspects of musical scene perception.


Assuntos
Perda Auditiva , Música , Percepção da Fala , Percepção Auditiva , Limiar Auditivo , Audição , Perda Auditiva/diagnóstico , Testes Auditivos , Humanos
2.
Tex Med ; 116(8): 4-5, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32866278

RESUMO

Like many areas of health care, hearing loss is best managed when hearing professionals collaborate closely with physicians. Primary care physicians (PCPs) are uniquely suited to manage hearing loss because 1) patients trust their PCP; 2) PCPs have insight into the overall health and well-being of their patients; and 3) the PCP workforce is large enough to make a meaningful impact. Accountable care organizations, clinically integrated networks, and patient-centered medical homes are perfectly suited to be a positive force in the hearing health of their patients.


Assuntos
Perda Auditiva/economia , Perda Auditiva/epidemiologia , Atenção Primária à Saúde , Organizações de Assistência Responsáveis , Demência/etiologia , Feminino , Auxiliares de Audição/economia , Perda Auditiva/diagnóstico , Perda Auditiva/reabilitação , Humanos , Masculino , Fatores de Risco , Texas
3.
Trends Hear ; 24: 2331216520932467, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32812519

RESUMO

Dissatisfaction with the sound of one's own voice is common among hearing-aid users. Little is known regarding how hearing impairment and hearing aids separately affect own-voice perception. This study examined own-voice perception and associated issues before and after a hearing-aid fitting for new hearing-aid users and refitting for experienced users to investigate whether it was possible to differentiate between the effect of (unaided) hearing impairment and hearing aids. Further aims were to investigate whether First-Time and Experienced users as well as users with dome and mold inserts differed in the severity of own-voice problems. The study had a cohort design with three groups: First-Time hearing-aid users going from unaided to aided hearing (n = 70), Experienced hearing-aid users replacing their old hearing aids (n = 70), and an unaided control group (n = 70). The control group was surveyed once and the hearing-aid users twice; once before hearing-aid fitting/refitting and once after. The results demonstrated that own-voice problems are common among both First-Time and Experienced hearing-aid users with either dome- or mold-type fittings, while people with near-normal hearing and not using hearing aids report few problems. Hearing aids increased ratings of own-voice problems among First-Time users, particularly those with mold inserts. The results suggest that altered auditory feedback through unaided hearing impairment or through hearing aids is likely both to change own-voice perception and complicate regulation of vocal intensity, but hearing aids are the primary reason for poor perceived sound quality of one's own voice.


Assuntos
Auxiliares de Audição , Perda Auditiva , Percepção da Fala , Estudos de Coortes , Perda Auditiva/diagnóstico , Humanos , Ajuste de Prótese
5.
Trends Hear ; 24: 2331216520945524, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32808881

RESUMO

A prospective clinical trial evaluated the effectiveness of cochlear implantation in adults with asymmetric hearing loss (AHL). Twenty subjects with mild-to-moderate hearing loss in the better ear and moderate-to-profound hearing loss in the poorer ear underwent cochlear implantation of the poorer hearing ear. Subjects were evaluated preoperatively and at 1, 3, 6, 9, and 12 months post-activation. Preoperative performance was evaluated unaided, with traditional hearing aids (HAs) or with a bone-conduction HA. Post-activation performance was evaluated with the cochlear implant (CI) alone or in combination with a contralateral HA (bimodal). Test measures included subjective benefit, word recognition, and spatial hearing (i.e., localization and masked sentence recognition). Significant subjective benefit was reported as early as the 1-month interval, indicating better performance with the CI compared with the preferred preoperative condition. Aided word recognition with the CI alone was significantly improved at the 1-month interval compared with preoperative performance with an HA and continued to improve through the 12-month interval. Subjects demonstrated early, significant improvements in the bimodal condition on the spatial hearing tasks compared with baseline preoperative performance tested unaided. The magnitude of the benefit was reduced for subjects with AHL when compared with published data on CI users with normal hearing in the contralateral ear; this finding may reflect significant differences in age at implantation and hearing sensitivity across cohorts.


Assuntos
Implante Coclear , Implantes Cocleares , Auxiliares de Audição , Perda Auditiva , Localização de Som , Percepção da Fala , Adulto , Perda Auditiva/diagnóstico , Perda Auditiva/terapia , Humanos , Estudos Prospectivos , Resultado do Tratamento
6.
BMC Med Genet ; 21(1): 151, 2020 07 18.
Artigo em Inglês | MEDLINE | ID: mdl-32682410

RESUMO

BACKGROUND: Hearing loss is the most common sensory defect, and it affects over 6% of the population worldwide. Approximately 50-60% of hearing loss patients are attributed to genetic causes. Currently, more than 100 genes have been reported to cause non-syndromic hearing loss. It is possible and efficient to screen all potential disease-causing genes for hereditary hearing loss by whole exome sequencing (WES). METHODS: We collected 5 consanguineous pedigrees from Pakistan with hearing loss and applied WES in selected patients for each pedigree, followed by bioinformatics analysis and Sanger validation to identify the causal genes. RESULTS: Variants in 7 genes were identified and validated in these pedigrees. We identified single candidate variant for 3 pedigrees: GIPC3 (c.937 T > C), LOXHD1 (c.6136G > A) and TMPRSS3 (c.941 T > C). The remaining 2 pedigrees each contained two candidate variants: TECTA (c.4045G > A) and MYO15A (c.3310G > T and c.9913G > C) for one pedigree and DFNB59 (c.494G > A) and TRIOBP (c.1952C > T) for the other pedigree. The candidate variants were validated in all available samples by Sanger sequencing. CONCLUSION: The candidate variants in hearing-loss genes were validated to be co-segregated in the pedigrees, and they may indicate the aetiologies of hearing loss in such patients. We also suggest that WES may be a suitable strategy for hearing-loss gene screening in clinical detection.


Assuntos
Consanguinidade , Perda Auditiva/genética , Mutação/genética , Sequenciamento Completo do Exoma , Feminino , Perda Auditiva/diagnóstico , Humanos , Masculino , Paquistão , Linhagem , Reprodutibilidade dos Testes
8.
Acta otorrinolaringol. esp ; 71(3): 166-174, mayo-jun. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-192632

RESUMO

INTRODUCCIÓN: La hipoacusia neurosensorial (HNS) es el déficit sensorial más prevalente en nuestro medio. La secuenciación genómica de nueva generación (NGS) permite obtener un diagnóstico etiológico en un alto porcentaje de pacientes. Nuestro estudio piloto muestra los resultados de la aplicación sistemática de la NGS en una Unidad de Hipoacusia Infantil, así como sus implicaciones en el manejo clínico de los pacientes y sus familiares. MATERIAL Y MÉTODO: Se incluyó a 27 pacientes diagnosticados de HNS entre 2014 y 2017 en los que se descartó una causa ambiental. El test genético consistió en un panel de genes analizados mediante NGS (panel OTOgenicsTM). Este panel ha sido diseñado para incluir genes asociados con hipoacusia neurosensorial o mixta, de inicio precoz o tardío, sindrómica y no sindrómica, independientemente de su patrón de herencia. RESULTADOS: Se obtuvo un diagnóstico genético en el 56% (15/27) de los pacientes (62% en el caso de las HNS bilaterales); 5/27 (19%) presentaron variantes patogénicas en el gen GJB2 y el resto variantes patogénicas o probablemente patogénicas en otros genes asociados con HNS aislada (PR2X2, TECTA y STRC), con HNS sindrómicas (CHD7, GATA3, COL4A5, MITF y SOX10) o con HNS sindrómicas y no sindrómicas (BSND, ACTG1 y CDH23). DISCUSIÓN: El diagnóstico etiológico de la HNS supone un desafío en la práctica clínica. Nuestra serie demuestra que es posible implementar el diagnóstico genético en la rutina asistencial y que esta información tiene implicaciones pronósticas y terapéuticas


INTRODUCTION: Sensorineural hearing loss (SNL) is the most prevalent sensory deficit in our environment. Next generation genomic sequencing (NGS) enables an aetiological diagnosis in a high percentage of patients. Our pilot study shows the results of the systematic application of NGS in a Childhood Hearing Loss Unit, as well as its implications for the clinical management of patients and their families. MATERIAL AND METHOD: We included 27 patients diagnosed with SNL between 2014 and 2017, in which an environmental cause was ruled out. The genetic test consisted of a panel of genes analyzed by NGS (OTOgenicsTM panel). This panel has been designed to include genes associated with sensorineural or mixed hearing loss, early onset or late, syndromic and non-syndromic, regardless of their inheritance pattern. RESULTS: A genetic diagnosis was obtained in 56% (15/27) of the patients (62% in the case of bilateral SNL). Of the patients, 5/27 (19%) presented pathogenic variants in the GJB2 gene and the rest pathogenic and / or probably pathogenic variants in other genes associated with isolated SNL (PR2X2, TECTA and STRC), with syndromic SNL (CHD7, GATA3, COL4A5, MITF and SOX10) or with syndromic and non-syndromic SNL (BSND, ACTG1 and CDH23). DISCUSSION: The aetiological diagnosis of SNL is a challenge in clinical practice. Our series demonstrates that it is possible to implement genetic diagnosis in the care routine and that this information has prognostic and therapeutic implications


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Perda Auditiva/diagnóstico , Perda Auditiva/genética , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Perda Auditiva/etiologia , DNA/genética , Variação Estrutural do Genoma/genética
9.
Artigo em Inglês | MEDLINE | ID: mdl-32512885

RESUMO

The present study aimed to develop a healthcare application for the elderly who suspect or know they have a hearing loss, namely, the Hearing Rehabilitation for Older Adults (HeRO), which is available in a mobile device, and then to confirm its probability of acceptance among elderly users. Under a web server system, HeRO which had four types of tailored training for the aged auditory system (i.e., syllable, sentence, discourse, working memory) and a self-reported questionnaire to screen amount of the hearing loss was completed for the elderly. To verify whether the HeRO contents and functions were user-friendly to the elderly users, the technology acceptance model (TAM) was used. Forty-four older adults were asked to use the developed application for 10 days and then respond to a TAM questionnaire with 25 items. The Cronbach's α coefficient of each subcategory was very high. The construct validity of all subcategories showed high eigenvalues using principal component analysis. Furthermore, our regression model statistically supported a persuasive intention to use the healthcare application because the elderly readily accept it and find it easy to manipulate. We expect the current technology to be applied to the general public as well as the elderly who want to explore digital health.


Assuntos
Perda Auditiva , Aplicativos Móveis , Aceitação pelo Paciente de Cuidados de Saúde , Idoso , Perda Auditiva/diagnóstico , Perda Auditiva/terapia , Humanos , Intenção , Memória de Curto Prazo , Inquéritos e Questionários
10.
Rev Saude Publica ; 54: 44, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32374803

RESUMO

OBJECTIVE: To evaluate Newborn Hearing Screening Program of Hospital Regional de Sobradinho, from January 2016 to December 2017, according to Multiprofessional Committee on Auditory Health parameters and Joint Committee on Infant Hearing (JCIH) recommendations, as well as to describe the prevalence of risk factors for hearing loss within the study population and their impact on the respective program. METHOD: This is a quantitative, cross-sectional and retrospective study that carefully analyzed registration books of screened newborns. It was established the prevalence of "pass" and "fail" in test and retest, retest percentage of attendance and referral for audiological diagnosis. Risk factors for hearing loss were described, as well as their influence on "pass" and "fail" rates. Inferential statistical analysis was performed using chi-square test and Anderson-Darling test, with 5% reliability index. RESULTS: A total of 3,981 newborns were screened; 2,963 (74.4%) presented no risk factors whereas 1,018 (25.6%) did, prematurity being the most frequent (51.6%). In the test, 166 (4.2%) failed and 118 (71.1%) attended the retest. The referral rate for diagnosis was 0.3%. CONCLUSION: Regarding the percentage of referral for diagnosis, the program reached indexes recommended by the Joint Committee on Infant Hearing and Multiprofessional Committee on Auditory Health. The most prevalent risk factor within the population was prematurity.


Assuntos
Testes Auditivos/métodos , Triagem Neonatal/métodos , Avaliação de Programas e Projetos de Saúde , Brasil/epidemiologia , Estudos Transversais , Perda Auditiva/diagnóstico , Perda Auditiva/epidemiologia , Testes Auditivos/normas , Testes Auditivos/estatística & dados numéricos , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Registros Médicos , Triagem Neonatal/normas , Prevalência , Estudos Retrospectivos , Fatores de Risco
11.
Clin Interv Aging ; 15: 635-643, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32440106

RESUMO

Background: Hearing loss (HL) is associated with poor physical functioning among older adults, yet this association has not been examined in heart failure (HF), a disease in which both hearing loss and poor physical functioning are highly prevalent. We investigated whether this association exists in HF since HL represents a potentially modifiable risk factor for poor physical functioning. Methods: We studied adults aged ≥70 years with self-reported HF in the National Health and Nutrition Examination Survey (NHANES). HL was assessed and categorized using pure-tone averages. Activities of daily living (ADLs), instrumental ADLs (IADLs), leisure and social activities (LSA), lower extremity mobility (LEM), and general physical activity (GPA) were assessed. Negative binomial regression was used to examine the association between HL and physical functioning Results: One hundred eighty-one participants comprised our population. Those with ≥ moderate HL had more difficulty with ADLs (37.0% vs 24.0%, p=0.02), IADLs (36.0% vs 23.0%, p=0.05), and LEM (37.3% vs 20.0%, p=0.009), compared to participants with none or mild HL. In multivariable models, ≥ moderate HL was significantly associated with difficulty in physical functioning across four of the five domains: ADLs: PR: 1.71 (95% CI: 1.07-2.72); IADLs: PR: 1.71 (1.24-2.34); LEM: PR: 1.51 (1.01-2.26); and GPA: PR: 1.19 (1.00-1.41). Conclusion: Among older adults with HF, moderate or greater HL was associated with a higher prevalence of difficulty with ADLs, IADLs, and LEM, compared to mild or no HL.


Assuntos
Exercício Físico , Perda Auditiva/epidemiologia , Insuficiência Cardíaca/epidemiologia , Desempenho Físico Funcional , Participação Social , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Feminino , Perda Auditiva/diagnóstico , Humanos , Atividades de Lazer , Extremidade Inferior/fisiologia , Masculino , Inquéritos Nutricionais , Fatores de Risco
12.
Thorax ; 75(8): 632-639, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32409613

RESUMO

INTRODUCTION: Individuals with chronic lung disease (eg, cystic fibrosis (CF)) often receive antimicrobial therapy including aminoglycosides resulting in ototoxicity. Extended high-frequency audiometry has increased sensitivity for ototoxicity detection, but diagnostic audiometry in a sound-booth is costly, time-consuming and requires a trained audiologist. This cross-sectional study analysed tablet-based audiometry (Shoebox MD) performed by non-audiologists in an outpatient setting, alongside home web-based audiometry (3D Tune-In) to screen for hearing loss in adults with CF. METHODS: Hearing was analysed in 126 CF adults using validated questionnaires, a web self-hearing test (0.5 to 4 kHz), tablet (0.25 to 12 kHz) and sound-booth audiometry (0.25 to 12 kHz). A threshold of ≥25 dB hearing loss at ≥1 audiometric frequency was considered abnormal. Demographics and mitochondrial DNA sequencing were used to analyse risk factors, and accuracy and usability of hearing tests determined. RESULTS: Prevalence of hearing loss within any frequency band tested was 48%. Multivariate analysis showed age (OR 1.127; (95% CI: 1.07 to 1.18; p value<0.0001) per year older) and total intravenous antibiotic days over 10 years (OR 1.006; (95% CI: 1.002 to 1.010; p value=0.004) per further intravenous day) were significantly associated with increased risk of hearing loss. Tablet audiometry had good usability, was 93% sensitive, 88% specific with 94% negative predictive value to screen for hearing loss compared with web self-test audiometry and questionnaires which had poor sensitivity (17% and 13%, respectively). Intraclass correlation (ICC) of tablet versus sound-booth audiometry showed high correlation (ICC >0.9) at all frequencies ≥4 kHz. CONCLUSIONS: Adults with CF have a high prevalence of drug-related hearing loss and tablet-based audiometry can be a practical, accurate screening tool within integrated ototoxicity monitoring programmes for early detection.


Assuntos
Fibrose Cística/complicações , Perda Auditiva/diagnóstico , Perda Auditiva/epidemiologia , Adulto , Audiometria , Computadores de Mão , Estudos Transversais , Fibrose Cística/terapia , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Adulto Jovem
14.
J Laryngol Otol ; 134(4): 293-301, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32301406

RESUMO

BACKGROUND: Ménière's disease is a debilitating chronic peripheral vestibular disorder associated with psychiatric co-morbidities, notably depression. METHODS: Database searches were performed to identify studies that assessed depression in Ménière's disease. Metrics used to diagnose depression were extracted, along with the prevalence of depression in each study. RESULTS: Fifteen studies from 8 different countries reported on 6587 patients. The weighted average age was 55.3 years (range, 21-88 years). Depression was measured by eight different scales, with Zung's Self-Rating Depression Scale used most often. A weighted proportion of 45.9 per cent of patients (confidence interval = 28.9-63.3) were depressed. Weighted averages (± standard deviations) of Beck's Depression Inventory and the Illness Behavior Questionnaire - Dysphoria were 8.5 ± 7.9 and 2.4 ± 1.7, respectively. CONCLUSION: The prevalence of depression in patients with Ménière's disease is nearly 50 per cent. Treating otolaryngologists should have a low threshold to screen and refer appropriately. Identifying and treating depression should allow for improvement of overall quality of life in patients with Ménière's disease.


Assuntos
Depressão/epidemiologia , Depressão/psicologia , Doença de Meniere/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Depressão/diagnóstico , Depressão/etiologia , Feminino , Perda Auditiva/diagnóstico , Perda Auditiva/etiologia , Humanos , Masculino , Doença de Meniere/complicações , Pessoa de Meia-Idade , Prevalência , Qualidade de Vida , Índice de Gravidade de Doença , Zumbido/diagnóstico , Zumbido/etiologia , Vertigem/diagnóstico , Vertigem/etiologia
15.
BMC Med Genet ; 21(1): 68, 2020 03 31.
Artigo em Inglês | MEDLINE | ID: mdl-32234020

RESUMO

BACKGROUND: The TWNK gene encodes the twinkle protein, which is a mitochondrial helicase for DNA replication. The dominant TWNK variants cause progressive external ophthalmoplegia with mitochondrial DNA deletions, autosomal dominant 3, while the recessive variants cause mitochondrial DNA depletion syndrome 7 and Perrault syndrome 5. Perrault syndrome is characterized by sensorineural hearing loss in both males and females and gonadal dysfunction in females. Patients with Perrault syndrome may present early-onset cerebellar ataxia, whereas middle-age-onset cerebellar ataxia caused by TWNK variants is rare. CASE PRESENTATION: A Japanese female born to consanguineous parents presented hearing loss at age 48, a staggering gait at age 53, and numbness in her distal extremities at age 57. Neurological examination revealed sensorineural hearing loss, cerebellar ataxia, decreased deep tendon reflexes, and sensory disturbance in the distal extremities. Laboratory tests showed no abnormal findings other than a moderate elevation of pyruvate concentration levels. Brain magnetic resonance imaging revealed mild cerebellar atrophy. Using exome sequencing, we identified a homozygous TWNK variant (NM_021830: c.1358G>A, p.R453Q). CONCLUSIONS: TWNK variants could cause middle-age-onset cerebellar ataxia. Screening for TWNK variants should be considered in cases of cerebellar ataxia associated with deafness and/or peripheral neuropathy, even if the onset is not early.


Assuntos
Ataxia Cerebelar/genética , DNA Helicases/genética , Proteínas Mitocondriais/genética , Ataxia Cerebelar/complicações , Ataxia Cerebelar/diagnóstico , Consanguinidade , Feminino , Marcha Atáxica/complicações , Marcha Atáxica/diagnóstico , Marcha Atáxica/genética , Disgenesia Gonadal 46 XX/diagnóstico , Disgenesia Gonadal 46 XX/genética , Perda Auditiva/complicações , Perda Auditiva/diagnóstico , Perda Auditiva/genética , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/genética , Homozigoto , Humanos , Japão , Transtornos de Início Tardio/diagnóstico , Transtornos de Início Tardio/genética , Pessoa de Meia-Idade , Mutação , Linhagem
16.
Int J Pediatr Otorhinolaryngol ; 134: 110041, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32289664

RESUMO

OBJECTIVES: Determining the frequency of and the risk factors for hearing loss among school-age children by comparing the results of hearing screening in children from Syrian refugee and native Turkish population. METHODS: The results of the official hearing test, which was conducted by the Ministry of Health of the Republic of Turkey for schoolchildren in the first grade in the 2017-2018 academic year in the Province of Sanliurfa, were analyzed. RESULTS: A total of 23,664 children were screened; 20,603 (87.1%) were Turkish native, and 3,061 (12.9%) were Syrian refugees. The age range was between 69 and 84 months. The screening results indicated in Turkish children, sensorineural hearing loss (SNHL) in 0.26%, otitis media with effusion (OME) in 0.41%, and chronic otitis media (COM) in 0.08%. In the refugee children, the frequency of SNHL was 1.11%, OME was 0.94%, and COM was 0.62%. The rate of COM and SNHL was significantly higher in the refugee children (p < 0.001). Moreover, among those with hearing loss, the frequency of low birth weight, inflammatory diseases, and the family history of consanguineous marriage was significantly higher in refugee children compared to those in Turkish native population (p = 0.018, p = 0.003, and p = 0.022, respectively). CONCLUSION: Hearing loss is a major preventable and treatable cause of developmental disorder in childhood. When untreated, hearing loss may delay speaking and prevent socio-emotional development, leading to longterm negative consequences. We believe that programs for hearing screening in schoolchildren should be expanded and that immigrants who carry several risk factors for developmental hearing loss should be included in these programs.


Assuntos
Perda Auditiva Neurossensorial/diagnóstico , Otite Média com Derrame/diagnóstico , Refugiados/estatística & dados numéricos , Audiometria , Criança , Pré-Escolar , Doença Crônica , Consanguinidade , Feminino , Perda Auditiva/diagnóstico , Perda Auditiva/epidemiologia , Perda Auditiva Neurossensorial/epidemiologia , Testes Auditivos , Humanos , Recém-Nascido de Baixo Peso , Masculino , Programas de Rastreamento , Otite Média/diagnóstico , Otite Média/epidemiologia , Otite Média com Derrame/epidemiologia , Encaminhamento e Consulta , Fatores de Risco , Síria/etnologia , Turquia/epidemiologia
17.
Int J Pediatr Otorhinolaryngol ; 134: 110039, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32304854

RESUMO

OBJECTIVES: The EUSCREEN study compares the cost-effectiveness of paediatric hearing screening programmes and aims to develop a cost-effectiveness model for this purpose. Alongside and informed by the development of the model, neonatal hearing screening (NHS) is implemented in Albania. We report on the first year. METHODS: An implementation plan was made addressing objectives, target population, screening protocol, screener training, screening devices, care pathways and follow up. NHS started January 1st, 2018 in four maternity hospitals: two in Tirana, one in Pogradec and one in Kukës, representing both urban and rural areas. OAE-OAE-aABR was used to screen well infants in maternity hospitals, whereas aABR-aABR was used in neonatal intensive care units and in mountainous Kukës for all infants. Screeners' uptake and attitudes towards screening and quality of screening were assessed by distributing questionnaires and visiting the maternity hospitals. The result of screening, diagnostics, follow up and entry into early intervention were registered in a database and monitored. RESULTS: Screeners were keen to improve their skills in screening and considered NHS valuable for Albanian health care. The number of "fail" outcomes after the first screen was high initially but decreased to less than 10% after eight months. In 2018, 11,507 infants were born in the four participating maternity hospitals, 10,925 (94.9%) of whom were screened in the first step. For 486 infants the result of screening was not registered. For the first screen, ten parents declined, eight infants died and one infant was discharged before screening could be performed. In 1115 (10.2%) infants the test either could not be performed or the threshold was not reached; 361 (32,4%) of these did not attend the second screen. For the third screen 31 (34.4%) out of 90 did not attend. Reasons given were: parents declined (124), lived too far from screening location (95), their infant died (11), had other health issues (7), or was screened in private clinic (17), no reason given (138). CONCLUSIONS: Implementation of NHS in Albania is feasible despite continuing challenges. Acceptance was high for the first screen. However, 32.4% of 1115 infants did not attend the second screen, after a "fail" outcome for the first test.


Assuntos
Potenciais Evocados Auditivos do Tronco Encefálico , Perda Auditiva/diagnóstico , Testes Auditivos/métodos , Triagem Neonatal/métodos , Emissões Otoacústicas Espontâneas , Albânia , Análise Custo-Benefício , Feminino , Perda Auditiva/congênito , Testes Auditivos/economia , Maternidades , Humanos , Ciência da Implementação , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Masculino , Triagem Neonatal/economia , Alta do Paciente
18.
Laryngorhinootologie ; 99(6): 400-406, 2020 06.
Artigo em Alemão | MEDLINE | ID: mdl-32252121

RESUMO

BACKGROUND: An untreated hearing impairment could have a severe influence on the morbidity. The Mini-Audio-Test (MAT) has been developed for early detecting of a relevant hearing loss. This follow-up investigation should determine the sensitivity, specificity, and the predictive values for a minimum-level of detected hearing loss of 25, 30, 35, and 40 dB, both, in one octave-frequency between 0.5 and 4 kHz and the average of hearing loss for these four frequencies. METHODS: This survey uses data which were collected in 2016 and 2017. 943 patients parted into two groups (aged 50 to 59 years and aged 60 years and more), were investigated using the MAT. Statistical analysis on the sensitivity, specificity, and predictive values in respect were done as proportions together with the 95 %-confidence interval by a logistic regression. RESULTS: The sensitivity of the MAT was increasing in both groups of age by increasing the minimum of to be detected hearing loss. The specificity was decreasing as well, but less. The positive predictive values were higher for the older age-group and are decreasing by increasing of the minimum of to be detected hearing loss. In general, the values using the averaged hearing loss are noticeably lower than for the single frequency detecting. The values for the negative predictive values were contrary. CONCLUSION: The results for persons aged 60 years and more are worse than for the younger. Therefore, a first screening on hearing loss starting at the age of 50 years seems to be recommended urgently. Only by this, a sufficient rehabilitation of the hearing loss could be done in time so that the negative consequences of an untreated hearing impairment could be influenced positively.


Assuntos
Surdez , Perda Auditiva , Idoso , Audiometria de Tons Puros , Perda Auditiva/diagnóstico , Humanos , Programas de Rastreamento , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Inquéritos e Questionários
19.
Int J Pediatr Otorhinolaryngol ; 134: 110017, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32251971

RESUMO

INTRODUCTION: Down Syndrome (DS) is a Tier 1 risk factor for hearing loss. Guidelines exist to ensure close monitoring of children with DS for hearing loss. It is important to consider the timing of testing in order to obtain meaningful audiologic data in this high-risk population. The purpose of this study is to present hearing outcomes for children with DS during the first 8 years of life and to assess these outcomes in the context of current screening guidelines. METHODS: Retrospective review of audiometric outcomes was conducted for children with DS age 8 or younger who presented to a multidisciplinary DS clinic between January 2014 to June 2017. Age at the time of testing, as well as test success rate and hearing loss type and severity were noted. RESULTS: 131 patients were included in the study, 52% of which were male. 36% of the patients failed their newborn hearing screening and only 9% of those subjects had normal hearing on subsequent testing. Most hearing loss identified was mild and conductive in nature. Inconclusive results were most likely to be obtained at 6-10 months of age. CONCLUSION: Hearing loss is common among children with DS. To optimize the quality of testing and avoid the need for sedation in followup testing, routine follow-up hearing screening should be performed either before 6 months of age or after 10 months of age.


Assuntos
Audiometria , Síndrome de Down/complicações , Perda Auditiva/diagnóstico , Fatores Etários , Criança , Pré-Escolar , Feminino , Perda Auditiva/etiologia , Humanos , Lactente , Recém-Nascido , Masculino , Triagem Neonatal , Seleção de Pacientes , Guias de Prática Clínica como Assunto , Estudos Retrospectivos , Fatores de Risco
20.
Int J Pediatr Otorhinolaryngol ; 134: 110036, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32335463

RESUMO

INTRODUCTION: Antiretroviral therapy (ART) has had a major impact on life expectancy from HIV as many people now live with it as a chronic disease. Chronic HIV has been associated with a range of comorbid disabilities and health conditions, one of which is hearing loss. Undiagnosed and untreated hearing loss, particularly in children, has been linked to poorer spoken language skills, with subsequent effects on academic performance. METHODS: This systematic scoping review aimed to summarize the available peer-reviewed literature on hearing loss in HIV-infected children, specifically to describe its extent and nature. The review followed the framework proposed by Arksey and O'Malley. Key search terms included hearing loss (and synonyms), child (and synonyms), and HIV. Electronic databases (EBSCOhost Research Platform, PubMed, Web of Science and Scopus databases) were searched for any relevant articles published from January 1, 2000 to June 30, 2019. Reference lists of included articles were pearled for additional relevant articles not already identified. Each stage of the selection process was conducted independently by two authors. The results were then collated by a third author who also resolved any discrepancies. Extracted data included sample descriptors, audiologic tests, hearing loss prevalence, hearing loss descripts, and factors associated with hearing loss. RESULTS: Seventeen articles were included; 10 from Africa, four from South America, two from North America and the remaining article from Asia. Although most of the articles reported on pure tone audiometry, the samples as well as the cut-off criteria for normal hearing were heterogenous. Prevalence of hearing loss varied across articles (from 6% to 84%). Conductive hearing loss occurred more frequently than sensorineural or mixed hearing loss. ART use and ear infection were reported as significant in three of five articles that reported on significant associates of HIV-related hearing loss. CONCLUSION: There was a modest volume of research from a limited number of countries. Heterogeneity in sampling and audiometric methods precluded a clear understanding of potential associations between chronic HIV-related hearing loss and contributing factors.


Assuntos
Infecções por HIV/complicações , Perda Auditiva/virologia , Criança , Perda Auditiva/diagnóstico , Perda Auditiva/epidemiologia , Humanos , Prevalência
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